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BookREVIEW: Their Finest Hour

.Jeffrey A Kottler and Jon Carlson

Crown House Publishing Ltd, 2008, pp377

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Reviewer: Claire Asherson Bartram

This book consists of the accounts from twenty-seven renowned therapists (two of these being the authors) who were each asked ‘What is your finest hour?’ The resulting narratives contrast in such areas as the interpretation of ‘finest hour’, the type of case chosen, the construction of what is important in psychotherapy, the framing of human problems, what people are seeking in therapy, what the therapist’s job is and the personality of the ‘master therapist’. The final chapter provides a synthesis and analysis which looks at common themes and what constitutes excellent therapy. The nature of ‘a finest hour’ is not explored in depth, however if you are like me and enjoy bite-sized stories and case studies of therapeutic work, you will find this book very enjoyable.

As mentioned above, each practitioner made their own interpretation of ‘finest hour’ and not all were transformational sessions. In the first narrative, Jon Carlson describes a case that could be seen as a failure because it has no resolution. This is the story of his work with several generations of a family struggling with a legacy of abuse. “Good or great therapy is not my work; it is the clients’ effort that determines that”. This is not so much a finest hour as an example of providing consistent support and respect for his clients. Carlson says: ”this case taught me so much about faith and resilience (p43)”. Nick Cummings describes work that appears to have contributed to prolonging the life of a dying man. In this he practiced ‘Extreme Therapy’ and his choice of finest hour is a time when he provoked his client in order to ‘mobilize rage’. ‘If you want to save a life you have to find the anger’. Alvin Mahrer chose a session that moved him deeply, in which he shared an out-of-body experience with his client. One of the few women represented in this book is Laura Brown who felt that she had done something wrong when she was unable to hold back tears in a session; however unknown to her at the time, this was the moment of change for her client. Brown described the crucial dynamic as ‘the anger and the attachment’ experienced at the same time by the client (p146) which she as therapist sat with. “With Alice I didn’t go away when she was angry with me. I didn’t get distant. I was there with her through this work.”

Although I found the narratives of compelling, while reading this book I could not ignore my dissatisfaction with how participants have been awarded the title of ‘Master Therapist’. It seems that the important factors are fame and hard work. The therapists chosen are largely individuals who are well placed in universities and hospitals and institutes. Many have developed their own theories and practices, rather than following a pre-existing orientation and a wide range of interventions and underlying philosophies is represented. The orientations and methods that the participants practice and/or have pioneered include: Cognitive and Hypnotic based therapies, Non-therapy, Emotionally Focused Therapy (EFT), Clinical Hypnosis, Reality Therapy, Extreme Therapy, Feminist Therapy, Resource Focused Therapy, Behaviour Therapy, Rational Emotive Based Therapy and so forth. Major strands of psychotherapeutic thinking are either not included, or represented by one practitioner; thus there is one analytically trained couples therapist, one Gestalt therapist and several family therapists. Because of this the ‘master therapists’ are not representative of the larger community, major strands of therapeutic thought are ignored and the stories are predominantly about action and short-term work. I felt that it would have been helpful if Kottler and Carlson had been clear about their biases and included a definition of ‘Master Therapists’ at the start of the book. What they have done is choose a selection of prominent practitioners without further analysis. Their method is reminiscent of Maslow who identified people as ‘self-actualised’ through picking them himself and declaring them as being so; a way of selection that he acknowledged was flawed.

Prior to their narrative each person is briefly described and in several cases this includes an account of prolific output. Thus several contributors are said to have published ‘hundreds of papers’ and others are described as working huge numbers of hours. For example Carlson, one of the book’s authors says that he ‘used to see seventy to eighty clients per week and this is in addition to his “day job”)’ and Nick Cummings is described as seeing forty to fifty patients a week, working from 3.00 am in the morning with ‘45 minute back-to-back sessions enabling him to see four patients in a 3-hour period for two stretches of 21 hours each’ (p99). I wonder what the personal cost to these individuals is for such a daunting schedule. Clearly they would have little time for life outside the therapy room. These instances of underlying work ethics held by the authors perhaps demonstrates pressure for delivery of service brought to bear on the individuals concerned, rather than proof that they are exemplary therapists.

I am also uneasy about the fact that most of the Master Therapists here are men (as well as being white and American). Only five contributors to the book are women despite them being the majority in the profession. However, the fact that prominent therapy practitioners tend to be male exists throughout the field. For example, it is striking that pioneers of psychotherapy in the Humanistic field are predominantly male – eg Viktor Frankl, Abraham Maslow, Carl Rogers, Albert Ellis, Carl Rogers, Fritz Perls, Eric Berne, to name a few. There seem to be more prominent women in the analytic and family therapy worlds. This imbalance is not noted by Kottler and Carlson whose only breakdown of contributors is in terms of themes and plotlines.

One of the main problems I have with this book is that while there are clear limitations in representation of type of therapeutic work, culture and gender, this is not acknowledged. The assumptions of the authors are not questioned and therefore there is a lack of perspective for any conclusions drawn by them here.

Despite having limitations in perspective and context as described above, this book provides a contribution to an inquiry into the nature of what works in therapy – the transformational moment. This is a project in a truly collaborative spirit, one where the researchers (writers) have been influenced and changed by their research. Its narrative form of first person accounts are compelling and provide much food for thought. The authors convey an enthusiasm for the field and describe how meeting and talking to the people who contributed their finest hours was a moving and humbling experience. Therefore there is a lot to recommend in this book; not least that it is a good read.

Dr. Claire Asherson Bartram is a Gestalt based integrative therapist, supervisor and group leader working in private practice; she is also a tutor and supervisor at the Minster Centre. Since qualifying in 1991 Claire has worked in a variety of settings and roles, including Counseling Coordinator at Brent MIND and supervising for the Mapesbury Clinic, a multicultural counseling service for refugees and asylum-seekers attached to the Minster Centre. Her doctorate focused on the experiences of mothers in stepfamily situations and she founded the organisation StepIn ASAP; Advancing Stepfamily Awareness in Practice. www.gestaltworks.co.uk. Email: clairebartram@blueyonder.co.uk

References
Boerree, C.G. Abraham Maslow,  accessed 19 September 2011